I’d strongly suggest that she visit a GP for a formal consultation. As pointed out, she has clear risk factors for heart disease, especially in the context of experiencing symptoms such as a heavy heart and fatigue. It’s worth noting that certain ECG abnormalities can be non-specific. I’d still suggest for you to bring the actual recording of the old ECG down for the consultation (as well as all her other old medical notes/laboratory results) – it’s very helpful for the doctor to compare any current ECG readings against the old one that was taken.

Yes, 100% blocked arteries can be treated and many techniques exist nowadays. If the artery can be opened up through the normal route of blood flow it is called “antegrade” technique and there are newer specialized kits available for this technique. There are also techniques that have been developed in Japan over the years called “retrograde” technique which is a way of going through the blocked vessel in the reverse manner by approaching though other arteries.

I am afraid the evidence does point to the fact that there is a clear advantage both in terms of quality of life and mortality benefit (for instance in those patients who have a narrowing of more than 50% in the left main stem ie the major branch on the left side of the heart, only 50% will survive beyond three years on medical treatment alone). Of course mild to moderate narrowing in a small noncritical vessel will neither confer a survival advantage nor cause a dramatic change in your quality of life.

My general approach to palpitations involves a detailed history and examination, followed by investigations tailored to each patient’s clinical presentation. As there are many causes of palpitations, a detailed assessment is needed to distinguish the various causes. When looking out for irregular heart rhythms (arrhythmia) in particular, I pay attention to the heart rate (too slow or too fast?) , blood pressure (too low or too high?) , pulse (regular or irregular?) I will also auscultate the heart to check for abnormal heart sounds like murmurs.

Yes we do use devices occasionally to remove/shave/excise plaques but this is used in less than 5% of coronary angioplasties at present. The current devices licensed for plaque removal usage in the heart are called: Rotablator (a nickel plated brass burr with microscopic diamond crystals on it rotating at high speed) which excises the hard plaque tissue Excimer laser (which uses high energy light to dissolve plaque without harming healthy tissue) and Orbital atherectomy (which uses a diamond coated crown rotating at high speed to kind of “sand ” the calcium away).